St. Lucie Cares: Behavioral Health Resource Guide Survey

Through the Roundtable of St. Lucie County’s St. Lucie RISE initiative, we have identified significant challenges related to youth substance use and untreated mental illness within our community. To address these challenges, St. Lucie Cares-Behavioral Health Resource Guide seeks to centralize and simplify access to local mental health and substance use prevention and treatment services for youth and families. Please complete the information below to provide comprehensive and up-to-date information about your organization to help us better support our community.

1.Agency/Company Name

2.Physical Address

Address

Address 2

City/Town

ZIP/Postal Code

3.Address of additional location (if applicable)

Address

Address 2

City/Town

ZIP/Postal Code

4.Telephone Number

5.Primary Contact Representative

6.Email Address

7.Website

8.Service Days/Hours

9.Services Category (select all that apply)

Other (please specify)

10.Age of Client Served (select all that apply)

Youth (ages 0-12)

Adolescent (ages 12-18)

Adult (age 18 and up)

12.Documents Required

15.Brief Description of Services (i.e. what would you like the community to know about what you provide)

16.Is a referral needed? If yes, from where/whom?